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Introduction
There has been an increasing interest in EHRs in the healthcare sector as patients demand for safer and higher quality health and medical care.
This interest in EHR has gone hand in hand with a rise in the number of efforts made towards providing definitions of the term.
Various names have been used to describe EHRs which include: electronic medical record, electronic patient record, computer-stored patient record, ambulatory medical record, and computer-based medical record.
The aim of this presentation is to introduce a new EHR system to members of staff of a healthcare unit.
Importance of Information Access
Timely and accurate access of patient information is important in enhancing the quality of patient care.
Paper records have always been used as the main technique of organizing all available information related to the progress of patients as well as their diagnosis and treatment at a particular place (Hamilton, 2010).
This compressed storage system is expedient but is rife with numerous demerits which have been addressed by the electronic system.
Even if paper records can be duplicated, maintaining many copies of a single record is cumbersome due to limited storage space and the need to keep updating all health records.
The single-record system availed by the electronic health record system enables multiple providers to gain access to the records.
The system also makes it possible for providers who are geographically constrained to access the records.
The electronic health records are usually stored in different locations of the computer such as the main location, the hard drive and external storage facilities such as flash disks. It is thus easy to replace an electronic health record if the computer system crashes (Hamilton, 2010).
The electronic health records are usually stored in different locations of the computer such as the main location, the hard drive and external storage facilities such as flash disks. It is thus easy to replace an electronic health record if the computer system crashes (Hamilton, 2010).
Personal Health Information
Personal Health Information (PHI) refers to any information that is collected by healthcare providers to identify their clients (College of Nurses of Ontario, 2009).
PHI includes information such as the medical history of the client (and his family), physical, mental and psychological status, history of medical/health care received, among others.
PHI is more vulnerable to breaches of confidentiality for various reasons.
PHI is in some cases required by an insurance company of the client to facilitate coverage of the healthcare expenditures. In such situations, breaches in confidentiality can easily occur.
When a client is incapable of making his own decisions about the healthcare required (for instance comatose patients), the nurse may be forced to share his PHI with members of his family to who can make the decisions on the client’s behalf.
PHI enables employers to know about the health status of potential and actual employees, for instance, if the client smokes or has a terminal illness that may affect his productivity. A breach of confidentiality can occur if the employer requests for the personal information of the client without the knowledge and consent of the client (College of Nurses of Ontario, 2009).
Security Measures in Relation to HIPAA
The Health Insurance Portability and Accountability Act was enacted in 1996 by the United States Congress to enhance the privacy of patients’ information (Sullivan, 2004).
HIPPA requirements include:
- Providing patients with the documentation of their rights.
- Protection controls on data stored wither physically or in computer systems.
- Monitoring devices to track the activities of the organization’s information network.
- Carrying out risk evaluation, prevention of data loss, and instituting data handling policies.
In order to comply with HIPAA, various security measures can be taken including:
- Delegating the duty of HIPAA compliance to an individual or a team of individuals who will oversee the entire compliance process of the organization (Sullivan, 2004).
- Training of employees to create awareness about HIPAA: employees should be trained on the rules and regulations of HIPAA, ensuring the privacy and confidentiality of patient information, how to protect patient information, and who is allowed to access patient information (Sullivan, 2004).
- Restricting and monitoring access to patient information: access to PHI should be limited to only those who require it such as healthcare providers. Monitoring should be done to identify who used the PHI, at what time and how frequently. This can be achieved using identity and access management (IAM) tools (Sullivan, 2004).
- Use of data protection techniques such as firewalls and passwords to enhance the privacy and confidentiality of the PHI (Sullivan, 2004).
- Even though rigorous security measures should be put in place to protect the privacy of health information, it is also in the best interest of the patient for the EHR to be available to the authorized personnel for proper and lawful utilization (Sullivan, 2004).
Quality Improvement and Errors Reduction
An electronic health record can minimize the time taken to record information as well as the errors incurred in the process of documentation, thus enhancing the efficiency of healthcare employees.
In addition, while paper records increase the probability of medical errors due to illegible notes, electronic records minimize such errors because the records are in a manner that is legible.
The elimination or minimization of medical errors is one of the major concerns of clients when it comes to receipt of health and medical care.
Patient safety is highly advocated for and the implementation of electronic health records is a step in the right direction towards the achievement of patient safety (Hamilton, 2010).
Roles of Implementation Teams
The success of an EHR in a hospital largely depends on the implementation team. Taking into account the large size of the hospital, the implementation team will consist of representatives of: physicians, nurses, operations staff, financial auditor, super user, health information management staff and information systems staff. These individuals will make up the planning team.
The role of the planning team is to make sure that all elements of the EHR, including the security of the system and sources and availability of funds, are taken into consideration in planning, choosing, implementing, training and later use (Amatayakul & Lazarus, 2005).
Besides the planning team, the implementation team will also consist of consultants and legal counsel.
The consultant will act as the project manager who will help in clarifying the objectives of the HER, identification of appropriate suppliers, negotiation of contract, and implementation of the EHR system (Amatayakul & Lazarus, 2005).
Sustainability of the EHR should be ensured by involving all the members of the planning team in each stage.
The legal counsel’s role is to evaluate the terms and conditions of contracts and the compliance of the EHR with rules and regulations such as HIPAA (Amatayakul & Lazarus, 2005).
Discussion Guide
Do you think machine technology and caring can exist separately?
Yes. A nurse may be competent in the use of machines but not caring to the patients.
How is the harmonious relationship between machine technology and caring illustrated by nurses?
Nurses can use the machine technologies to have a better understanding of their patients so as to provide them with better and high-quality care.
What are some of the ways in which nurses can show their technological competence and nursing at the same time?
By grounding their practice on the framework of caring rather than on technological competence.
Need for frequent updating of patient information.
How possible is it to compromise caring of patients through machinery?
The possibility is high and therefore it is important for nurses to realize that machine technology should only be used by the nurses to know their patients as a whole and therefore the use of technology should not replace nurses’ caring.
How are technologies beneficial to nurses as far as caring is concerned?
When nurses are technological competent, they are able to find new and enhanced ways of building strong and healing relationships with their patients.
Name three characteristics of technology that differ from human beings and which influence caring by nurses.
Machines and technologies are invulnerable, objective, and predictable while human beings are vulnerable, subjective and unpredictable. Professional nurses are challenged to be technologically competent and at the same time to recognize human vulnerability in responding authentically and intentionally to calls of nursing.
When a machine/technology is used on a patient , how is the humaneness of caring achieved?
Even with the use of technology, nurses should always remember the human face behind the technology. They should not ignore the need of the patients for human interactions. Nurses should thus act as liaisons between the machines and the patients.
What are the requirements for the coexistence of technology and caring?
Successfully combining technology and caring requires sensitivity to patients’ physical, emotional and spiritual needs.
What is the dilemma of technology proficiency without the caring perspective?
The nurses fail to recognize their patients as human beings who are whole and therefore the aspect of caring is non-existent.
One of the hotly debated issues in nursing is “high-tech versus high-touch” debate. What are your opinions about this debate?
High technology plays an important role especially in the accuracy of data collected, diagnosis, treatment and therapy. However, too much focus on the technology is detrimental to patients’ care because little attention is given to patients. Therefore, nurses should integrate and strike a balance between high-tech and high-touch aspects of nursing.
Reference List
Amatayakul, M. K., & Lazarus, S.S. (2005). Electronic health records: transforming your medical practice. New York: Medical Group Management Association.
College of Nurses of Ontario. (2009). Confidentiality and Privacy – Personal Health Information. Toronto, ON: College of Nurses of Ontario.
Hamilton, B. (2010). Electronic Health Records. New York: McGraw-Hill.
Sullivan, J. (2004). HIPAA: A practical guide to the privacy and security of health data. Chicago, IL: American Bar Association.
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